Montana L S, Mishra V, Hong R
Department of Global Health and Population, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
Sex Transm Infect. 2008 Aug;84 Suppl 1(Suppl_1):i78-i84. doi: 10.1136/sti.2008.030106.
To compare HIV seroprevalence estimates obtained from antenatal care (ANC) sentinel surveillance surveys in Ethiopia, Kenya, Malawi, Tanzania and Uganda with those from population-based demographic and health surveys (DHS) and AIDS indicator surveys (AIS).
Geographical information system methods were used to map ANC surveillance sites and DHS/AIS survey clusters within a 15-km radius of the ANC sites. National DHS/AIS HIV prevalence estimates for women and men were compared with national prevalence estimates from ANC surveillance. DHS/AIS HIV prevalence estimates for women and men residing within 15 km of ANC sites were compared with those from ANC surveillance. For women, these comparisons were also stratified by current pregnancy status, experience of recent childbirth and receiving ANC for the last birth.
In four of the five countries, national DHS/AIS estimates of HIV prevalence were lower than the ANC surveillance estimates. Comparing women and men in the catchment areas of the ANC sites, the DHS/AIS estimates were similar to ANC surveillance estimates. DHS/AIS estimates for men residing in the catchment areas of ANC sites were much lower than ANC surveillance estimates for women in all cases. ANC estimates were higher for younger women than DHS/AIS estimates for women in ANC catchment areas, but lower at older ages. In all cases, urban prevalence was higher than rural prevalence but there were no consistent patterns by education.
ANC surveillance surveys tend to overestimate HIV prevalence compared to prevalence among women in the general population in DHS/AIS surveys. However, the ANC and DHS/AIS estimates are similar when restricted to women and men, or to women only, residing in catchment areas of ANC sites. Patterns by age and urban/rural residence suggest possible bias in the ANC estimates.
比较埃塞俄比亚、肯尼亚、马拉维、坦桑尼亚和乌干达通过产前保健（ANC）哨点监测调查获得的艾滋病毒血清流行率估计值与基于人群的人口与健康调查（DHS）和艾滋病指标调查（AIS）的估计值。
运用地理信息系统方法绘制ANC监测点以及ANC监测点半径15公里范围内的DHS/AIS调查群组的地图。将全国DHS/AIS艾滋病毒流行率对女性和男性的估计值与ANC监测的全国流行率估计值进行比较。将居住在ANC监测点15公里范围内的女性和男性的DHS/AIS艾滋病毒流行率估计值与ANC监测的估计值进行比较。对于女性，这些比较还按当前妊娠状态、近期分娩经历以及上次分娩接受ANC情况进行分层。
在这五个国家中的四个国家，全国DHS/AIS艾滋病毒流行率估计值低于ANC监测估计值。比较ANC监测点集水区内的女性和男性，DHS/AIS估计值与ANC监测估计值相似。在所有情况下，居住在ANC监测点集水区内的男性的DHS/AIS估计值远低于ANC监测对女性的估计值。ANC对年轻女性的估计值高于ANC集水区内女性的DHS/AIS估计值，但在老年时则较低。在所有情况下，城市流行率高于农村流行率，但按教育程度没有一致的模式。
与DHS/AIS调查中一般人群中的女性流行率相比，ANC监测调查往往高估艾滋病毒流行率。然而，当仅限于居住在ANC监测点集水区内的女性和男性或仅女性时，ANC和DHS/AIS估计值相似。年龄和城乡居住模式表明ANC估计值可能存在偏差。
